LENOIR CITY (WATE) – A single mother with four kids says she is at a crossroads after her insurance provider refused to cover her treatment.
Marla Cortez, 42, has an aggressive form of breast cancer, located right next to her heart and lung. Her oncology team prescribed proton radiation therapy, but unfortunately her insurance won’t cover the treatment. Cortez said she has appealed Aetna Insurance four times, but her only recourse is to pay $75,000 out of pocket.
“It’s very frustrating. You talk to everyone and they say tell you this is what you need. Then this insurance company, this big conglomerate, says no you don’t need it,” Marla said.
In March, a state Senate committee refused to act on a bill that would require health insurance companies to cover proton therapy treatment for cancer at the same levels it covers other radiation therapies. Knoxville’s Provision Center for Proton Therapy was behind the bill, but the insurance industry lobbied against the bill. That decision has left Cortez with very few options.
“We’ve been in this battle for a while even though proton therapy has been around for a long time. It’s probably more political than the technology itself,” explained Bill Hansen with the Provision Center for Proton Therapy, about how patients like Marla struggle to get covered by insurance providers.
“What we tend to see is that we treat a lot of children and older adults because Medicare covers it. So it’s been the people in the middle being denied this treatment,” he added.
The Lenoir City community has come together to help the single-mother raise money for treatment. Di’lishi, a new yogurt bar in Lenoir City created “Marvelous Marla Monday.” On Monday proceeds from yogurt purchased will benefit Cortez.
A friend of Cortez has also set up a GoFundMe page. The page has already received over $7,000 in donations.
“This is pretty overwhelming,” Marla said, about the community support.
Hansen says they’re pushing another bill in 2016 that would cover proton therapy for cancer patients.